The sounds of “Pomp and Circumstance” amidst a sea of caps and gowns signify major milestones in a young person’s life. Graduation carries additional meaning for those who were born facing adversities that could have prevented them from going to school altogether.
At UF Health Jacksonville, there’s a diverse team of experienced, dedicated providers who work diligently to see that ill and premature newborns have a chance at a healthy life. One of the neonatologists, Don Garrison, MD, recently took a moment to talk about his experiences at the hospital’s neonatal intensive-care unit, commonly called NICU.
Garrison began at UF Health Jacksonville in 1973, back when the facility was known as University Hospital. In July, he will have been here 41 years. He is also an associate professor of pediatrics at the University of Florida College of Medicine – Jacksonville.
Garrison said he welcomes the challenge of providing urgent treatment for critically ill newborns, whose health issues can be similar to trauma patients. For instance, many of the infants experience excessive bleeding, shock, or lack of oxygen with multi-organ dysfunction.
While a baby is in the NICU, parents often go through a myriad of emotions that include grief, denial, guilt and also fear that their child may face a permanent handicap or even death. Garrison said the biggest reward is seeing a NICU baby who’s become healthy enough to go home. The parents’ gratitude adds to the satisfaction.
“Many parents return months to years later to show us how well their infant is doing,” Garrison said. “Others send cards periodically to keep us informed on their child’s progress. One graduate many years later sent me an invitation to his high school graduation, which was very touching.”
But then there are unfortunate outcomes, which Garrison said are never easy to handle.
“Dealing with the death of an infant is tough – especially one who is the product of past failed pregnancies, or in whom we have invested emotionally, physically and with great resources to try to save,” he said.
NICU advancements
Garrison said advances in space exploration decades ago indirectly affected neonatology because monitoring and life-support technologies were miniaturized, allowing them to be used on premature babies.
“With the initial technology to monitor and the demonstration that very premature babies could be helped, there was an explosion of technological advances to support critically ill newborns,” he said.
Garrison said that 40 years ago, 28 weeks was the minimal gestational age needed for viability, and only a few of those babies survived. Today, 23 weeks is considered potentially viable, and at least 25 percent of those babies will survive.
“However, in recent years, preventing handicaps for these most premature infants has not improved, and we are still searching for ways to improve outcomes,” he said.
Many people may not realize how challenging and complex the operation of the NICU is, Garrison said. The medical director and nurse manager must ensure that the doctors, nurses and other staff are following the most up-to-date practices of patient care. Quality improvement, infection control and safety are also key, as well as providing an environment conducive to infant recovery and development.
Staff work closely with personnel in the nurseries, labor and delivery, obstetrics and maternal-fetal medicine to ensure quality care.
“Many people may also not realize that the care of a critically ill baby begins with the obstetric management of the mother to ensure the baby has the safest environment for development and the best care during any late complications,” Garrison said.
Support for NICU
UF Health Jacksonville’s NICU is an official charity this year of The Players Championship PGA golf tournament, which is May 5-11 at TPC Sawgrass in Ponte Vedra Beach, Florida. Wear orange and blue May 10 to show your support as the NICU is honored as the “charity of the day.”
For more information, visit www.chipinforyouth.com.